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Chemotherapy: Blood Cell Counts (Bone Marrow Changes)

Blood Cells And How They Are Affected By Chemotherapy

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© American Cancer Society 2010

Following is a description of each of these types of cells and how they are affected by chemotherapy:

  • Red blood cells (RBCs) carry oxygen from the lungs to all parts of the body. During chemo, the bone marrow may not be able to make enough red blood cells. Not having enough red blood cells is called anemia. It can make you feel short of breath, weak, and tired. Anemia can also make your skin, mouth, or gums look pale.
  • White blood cells (WBCs) fight infection. Chemo lowers your white blood cell count, which makes you less able to fight infections. Your cancer care team may ask you to do certain things to avoid infection, such as:
    • Staying away from people who have infections or fevers.
    • Eating only cooked foods (no raw foods, even fruits and vegetables).
    • Wash your hands very well and often.
      • Also consider wearing a surgical mask when in crowds or public places.
      • To learn more about avoiding unnecessary infection, see the following documents:
  • Platelets are tiny pieces that form blood clots to stop bleeding from cuts or bruises. If your bone marrow cannot make enough platelets, you may bleed too much, even from small cuts. If your platelet count is low, you will need to be very careful to avoid cuts, bruises, and other injuries. Even brushing your teeth with a hard bristle toothbrush could cause your gums to bleed. You may need a soft toothbrush or one made of a special foam. Check with your doctor or nurse about flossing.

Knowing what these 3 types of blood cells normally do can help you understand the effects of low blood cell counts.

  • WBCs help the body fight off infections.
  • Platelets help prevent bleeding by forming plugs to seal up damaged blood vessels.
  • RBCs bring oxygen to cells throughout the body so they can turn certain nutrients into energy.

The side effects caused by low blood cell counts will likely be at their worst when the WBC, RBC, and platelets are at their lowest levels.

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